Because QT-interval prolongation (QTIP) has been associated with sudden death in patients using liquid protein diets, the role of QTIP was investigated in 3 women, aged 29, 32 and 37 years, with anorexia nervosa in whom both necropsy and electrocardiograms were available for review. At death, they weighed 41.8, 23.5, and 31.0 kg, respectively. Electrocardiogram recorded less than 7 days before death in each showed prolonged Q-T intervals: 0.61, 0.47, and 0.46 sec, respectively, when corrected for heart rate. Terminal ventricular tachyarrhythmias were documented in 2 patients, including torsade de pointes in 1. The clinical and necropsy findings in these 3 patients provide evidence that sudden death in anorexia nervosa may result from QTIP and indicate the need for electrocardiographic monitorin of such patients.